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Home Blood Pressure Monitoring in Children and Adolescents: Systematic Review of Evidence on Clinical Utility

  • Prevention of Hypertension: Public Health Challenges (Y Yano , Section Editor)
  • Published:
Current Hypertension Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

For the accurate diagnosis and management of hypertension, out-of-office blood pressure evaluation using ambulatory (ABPM) or home monitoring (HBPM) is currently recommended. In children, there is considerable evidence on the clinical utility of ABPM, whereas the evidence on HBPM is limited. This systematic review presents (i) the benefits of HBPM in children; (ii) the evidence on normal range, diagnostic accuracy, and relationship with preclinical organ damage; and (iii) guidance for devices, monitoring schedule, and interpretation.

Recent Findings

HBPM is a useful adjunct to the conventional office measurements for the evaluation of children with suspected or treated hypertension. HBPM is feasible in children and has good reproducibility, diagnostic accuracy and acceptability by users, and relatively low cost. Thus, it has greater potential for widespread and long-term use than ABPM, which is more expensive and often not available or not tolerated. Automated monitors that have been clinically validated specifically in children should be used with appropriate cuff size. HBPM for 7 days (minimum 3) with duplicate morning and evening measurements (minimum 12 readings) should be performed in children with suspected or treated hypertension before each office visit. Until more data become available, in case of diagnostic disagreement between office blood pressure and HBPM, treatment decisions should be based on ABPM.

Summary

HBPM is clinically useful in children with hypertension. More research is needed on its clinical application, and more automated devices need to be clinically validated in this population.

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Authors and Affiliations

  1. Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Athens, Greece

    George Stergiou, Emelina Stambolliu, Ioanna Bountzona, Angeliki Ntineri & Anastasios Kollias

  2. First Department of Pediatrics, P&A Kyriakou Children’s Hospital, Athens, Greece

    Andriani Vazeou

  3. Second Department of Pediatrics, National and Kapodistrian University of Athens, School of Medicine, P&A Kyriakou Children’s Hospital, Athens, Greece

    Alexandra Soldatou

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  1. George Stergiou
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  2. Emelina Stambolliu
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  4. Angeliki Ntineri
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Correspondence to George Stergiou.

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Stergiou, G., Stambolliu, E., Bountzona, I. et al. Home Blood Pressure Monitoring in Children and Adolescents: Systematic Review of Evidence on Clinical Utility. Curr Hypertens Rep 21, 64 (2019). https://doi.org/10.1007/s11906-019-0967-2

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